OUTSOURCING YOUR CHIROPRACTIC BILLING &
COLLECTIONS
³ITıS A LEAP OF FAITH²
By
Dr. David Foster and Dr. Joseph Labriola
Axis Billing & Collections
Are you losing the ³battle² with insurance reimbursement? I say ³battle² because that is what it has
become. The insurance industryıs fiduciary responsibility is to their stockholders and profits, not
providers. They have internally mandated that they will create systems that will increase profits and
limit payment to all health care providers, especially chiropractors.
Why chiropractors? According to James J. Mathis, a former executive of Allstate and State Farm
insurance companies, ³There exists a discrimination of the chiropractic profession, which results in
chiropractic treatment billing being denied, in part and in whole.² In his recent article ³How to Get
Paid² in The American Chiropractor, Mr. Mathis reveals the true motivations in the insurance industry.
³Insurance industry claim departments were viewed as profit opportunity entities. Goals were
developed to produce billions of dollars from a reduction in claims payments.²
What has become commonplace in your office has become an extension of the insurance companiesı
request departments. They want claims to be uniquely submitted, and they employ tactics such as
reduced fee reimbursements, requests for complex documentation, and routinely postponed payments
that add to your struggles.
If you, the doctor, are allocating more time and energy to the documentation of the services performed
and less time to building a quality practice, you are the typical chiropractor. If your office insurance
billing staff is putting out a Herculean effort to collect claims, and reimbursement has continued to
stagnate, once again, you are the typical chiropractor. The insurance industryıs strategy is working!
Itıs not all dollars and cents though; the emotional wear and tear on you and your office staff will
continue to grow. We are in a ³David and Goliath² relationship with the insurance industry - how do
we endure when the odds are weighted against us?
We must alter the view of our practice. We must not only be in the practice of chiropractic, we must
be in the business of chiropractic. We can no longer run our practices as a ³mom and pop² candy store
when the biggest of businesses, the insurance companies, dictate our livelihood.
The most effective business model to combat insurance pressure is to separate the patient interaction
from the insurance billing and collections. Recognizing that front desk and insurance personalities are
completely different is the most important element. Your front office staff must be patient friendly,
loving and caring. By design, the patient will receive the maximum attention, instruction and
education to achieve the best results. In contrast, your insurance personnel must be aggressive, highly
motivated, detail­oriented, and educated to the newest procedures and nuances of each company. This
area requires strong personalities that will follow up on each claim submitted until it is paid. The
personality of each office task is in direct opposition to the other.
Equally as important is the outsourcing of the billing and collection of the service performed. The
probability that a chiropractic office with a staff that wears many hats can be as effective as an
organization whose sole purpose is to process and follow-up on claims is low at best. How can a single
office keep up with the constant changes in coding, claim submission protocol and constant follow-
up?
As a billing and collection company processing a large volume of chiropractic-only claims, we are able
to distill data and efficiently manage changes in insurance procedure. In this business, information is
powerful. As we obtain knowledge about a new code, documentation process, or insurance law, the
new information is applied and quickly distributed to our clients early in the learning curve.
Allowing a professional billing and collection organization to execute this arduous task will maximize
both areas within your practice. Imagine concentrating on patient education and care knowing that
billing and collection duties are being accomplished with a higher level of efficiency and lower costs.
The advantages of outsourcing billing and collection can easily be measured quantitatively, but the
value added is in the intangibles. Removing the headaches of dealing with insurance companies brings
a positive and upbeat energy to your office. You can then reprioritize to practice building and focus
on marketing, patient education, and employee encouragement.
What will it take to outsource billing and collections in your practice? Will it take further
deterioration of your collection percentage, or your insurance staff resigning and taking with them
every bit of vital information about your practice? The future of the business of chiropractic is
outsourcing the specific tasks to specialists that can do a better job.
For the typical chiropractor, itıs a ³leap of faith² - a leap that will allow you to concentrate on the
practice of chiropractic while having the confidence that motivated professionals are working for you
on the business of chiropractic.
David G. Foster, DC, co-owns and operates six Family Chiropractic Centers in New Jersey and has
been practicing for 14 years. He also writes and consults about multi-practice expansion, the buy/sell
process, practice evaluation, associate contracts, and shareholder agreements. Foster can be
reached at: (800) 908-3040; chirodave@aol.com; www.familychiropracticcenters.info.
Joseph Labriola, DC, has been in practice for 6 years. He is the co- owner of New City Chiropractic
Center in New City, NY, and is the co-founder of Axis Billing & Collections, a chiropractic billing
company based in New Jersey. He can be reached at (201) 997-6905, or by e-mail at info@axis-
billing.com.